Archive for September 28, 2008

Invasive Group B Streptococcal Infections in Infants, France

Emerging Infectious Diseases  October 2008  V.14  N.10

Claire Poyart,  Hélène Réglier-Poupet, Asmaa Tazi, Annick Billoët, Nicolas Dmytruk, Philippe Bidet, Edouard Bingen, Josette Raymond, and Patrick Trieu-Cuot

Institut National de la Santé et de la Recherche Médicale U567 Unité Mixte de Recherche Centre National de la Recherche Scientifique 810, Paris, France (C. Poyart, H. Réglier-Poupet, A. Tazi); Centre National de Référence des Streptocoque, Paris (C. Poyart, H. Réglier-Poupet, A. Tazi, N. Dmytruk, P. Bidet, E. Bingen, J. Raymond, P. Trieu-Cuot); Groupe Hospitalier Cochin-Saint Vincent de Paul, Paris, (C. Poyart, H. Réglier-Poupet, A. Tazi, A. Billoët, J. Raymond); and Institut Pasteur, Paris (C. Poyart, P. Trieu-Cuot)

Clinical features and molecular characterization of 109 group B streptococci causing neonatal invasive infections were determined over an 18-month period in France. Sixty-four percent of the strains were from late-onset infections, and 75% were capsular type III. The hypervirulent clone ST-17 was recovered in 80% of meningitis cases.

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September 28, 2008 at 1:18 pm Leave a comment

Ceftibuten Resistance and Treatment Failure of Neisseria gonorrhoeae Infection

Antimicrobial Agents and Chemotherapy  1 October 2008  V.52  N.10  p.3564-3567

Janice Y. C. Lo,1* K. M. Ho,2 Anna O. C. Leung,1 Felisa S. T. Tiu,1 Grand K. L. Tsang,1 Angus C. T. Lo,1 and John W. Tapsall3

Microbiology Division, Public Health Laboratory Services Branch,1 Social Hygiene Service, Public Health Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region,2 WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales, Australia3

Neisseria gonorrhoeae infections have been empirically treated in Hong Kong with a single oral 400-mg dose of ceftibuten since 1997. Following anecdotal reports of the treatment failure of gonorrhea with oral extended-spectrum cephalosporins, the current study was undertaken to determine the antimicrobial susceptibility pattern and molecular characteristics of isolates of N. gonorrhoeae among patients with putative treatment failure in a sexually transmitted disease clinic setting. Between October 2006 and August 2007, 44 isolates of N. gonorrhoeae were studied from patients identified clinically to have treatment failure with empirical ceftibuten. The ceftibuten MICs for three strains were found to have been 8 mg/liter. These strains were determined by N. gonorrhoeae multiantigen sequence typing to belong to sequence type 835 (ST835) or the closely related ST2469. The testing of an additional eight archived ST835 strains revealed similarly elevated ceftibuten MICs. The penA gene sequences of these 11 isolates all had the mosaic pattern previously described as pattern X. Of note is that the ceftriaxone susceptibility results of these strains all fell within the susceptible range. It is concluded that ceftibuten resistance may contribute to the empirical treatment failure of gonorrhea caused by strains harboring the mosaic penA gene, which confers reduced susceptibility to oral extended-spectrum cephalosporins. Screening for such resistance in the routine clinical laboratory may be undertaken by the disk diffusion test. The continued monitoring of antimicrobial resistance and molecular characteristics of N. gonorrhoeae isolates is important to ensure that control and prevention strategies remain effective.


September 28, 2008 at 1:16 pm Leave a comment

Rise and Persistence of Global M1T1 Clone of Streptococcus pyogenes

Emerging Infectious Diseases  October 2008  V.14  N.10

Ramy K. Aziz  and Malak Kotb

Cairo University, Cairo, Egypt (R.K. Aziz); VA Medical Center, Memphis, Tennessee, USA (R.K. Aziz, M. Kotb); University of Tennessee Health Science Center, Memphis (M. Kotb); and University of Cincinnati, Cincinnati, Ohio, USA (M. Kotb)

The resurgence of severe invasive group A streptococcal infections in the 1980s is a typical example of the reemergence of an infectious disease. We found that this resurgence is a consequence of the diversification of particular strains of the bacteria. Among these strains is a highly virulent subclone of serotype M1T1 that has exhibited unusual epidemiologic features and virulence, unlike all other streptococcal strains. This clonal strain, commonly isolated from both noninvasive and invasive infection cases, is most frequently associated with severe invasive diseases. Because of its unusual prevalence, global spread, and increased virulence, we investigated the unique features that likely confer its unusual properties. In doing so, we found that the increased virulence of this clonal strain can be attributed to its diversification through phage mobilization and its ability to sense and adapt to different host environments; accordingly, the fittest members of this diverse bacterial community are selected to survive and invade host tissue.

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September 28, 2008 at 1:14 pm Leave a comment

Widespread Oseltamivir Resistance in Influenza A Viruses (H1N1), South Africa

Emerging Infectious Diseases  October 2008  V.14  N.10

Besselaar TG, Naidoo D, Buys A, Gregory V, McAnerney J, Manamela JM, et al.

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September 28, 2008 at 1:12 pm Leave a comment

Penetration of Chlorhexidine into Human Skin

Antimicrobial Agents and Chemotherapy  1 October 2008  V.52  N.10  p.3633-3636

T. J. Karpanen,1* T. Worthington,1 B. R. Conway,1 A. C. Hilton,1 T. S. J. Elliott,2 and P. A. Lambert1

Life and Health Sciences, Aston University, Aston Triangle, Birmingham B4 7ET, United Kingdom,1 Selly Oak Hospital, University Hospital Birmingham NHS Foundation Trust, Raddlebarn Road, Selly Oak, Birmingham B29 6JD, United Kingdom2

This study evaluated a model of skin permeation to determine the depth of delivery of chlorhexidine into full-thickness excised human skin following topical application of 2% (wt/vol) aqueous chlorhexidine digluconate. Skin permeation studies were performed on full-thickness human skin using Franz diffusion cells with exposure to chlorhexidine for 2 min, 30 min, and 24 h. The concentration of chlorhexidine extracted from skin sections was determined to a depth of 1,500 µm following serial sectioning of the skin using a microtome and analysis by high-performance liquid chromatography. Poor penetration of chlorhexidine into skin following 2-min and 30-min exposures to chlorhexidine was observed (0.157 ± 0.047 and 0.077 ± 0.015 µg/mg tissue within the top 100 µm), and levels of chlorhexidine were minimal at deeper skin depths (less than 0.002 µg/mg tissue below 300 µm). After 24 h of exposure, there was more chlorhexidine within the upper 100-µm sections (7.88 ± 1.37 µg/mg tissue); however, the levels remained low (less than 1 µg/mg tissue) at depths below 300 µm. There was no detectable penetration through the full-thickness skin. The model presented in this study can be used to assess the permeation of antiseptic agents through various layers of skin in vitro. Aqueous chlorhexidine demonstrated poor permeation into the deeper layers of the skin, which may restrict the efficacy of skin antisepsis with this agent. This study lays the foundation for further research in adopting alternative strategies for enhanced skin antisepsis in clinical practice.


September 28, 2008 at 1:05 pm Leave a comment


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